Nonopioid additives to local anaesthetics for caudal blockade in children: a systematic review

Ansermino, J. Mark; Basu, Rahul; Vandebeek, Christine A.; Montgomery, Carolyne J.

doi:10.1046/j.1460-9592.2003.01048.x

Cited by 154 publications

(119 citation statements)

References 75 publications

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“…In children, addition of clonidine to bupivacaine caudal injection increased the duration (Ansermino et al, 2003 Level I) and quality of analgesia without an increase in side effects (Yildiz et al, 2006 Level II) (see also Section 10.7.2).…”

Section: Level Ii)mentioning

confidence: 99%

“…Concentration-dependent differences have been noted; ropivacaine 0.175% was superior to lower concentrations, and was as effective as a 0.2% solution but produced less motor block (Khalil et al, 2006 Level II). Addition of adrenaline to bupivacaine has minimal effect on the duration of analgesia, particularly in older children (Ansermino et al, 2003 Level I).…”

Section: Caudal Analgesiamentioning

confidence: 99%

“…Effects on analgesic efficacy could not be assessed by metaanalysis due to variability in study design and outcome measures. Clinically important sedation occurred with higher doses (5 mcg/kg) (Ansermino et al, 2003 Level I). Clonidine 1 mcg/kg with ropivacaine 0.2% has been shown to have a longer duration than either ketamine 0.5% with ropivacaine or plain ropivacaine (Akbas et al, 2005 Level II).…”

Section: Chapter 10mentioning

confidence: 99%

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Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Level Ii)mentioning

confidence: 99%

Section: Caudal Analgesiamentioning

confidence: 99%

Section: Chapter 10mentioning

confidence: 99%

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Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…Repair under local anesthesia may be preferred in suitable cases because some patients prefer not to undergo general anesthesia, concerned about potential complications contributing to increased need for specialist consultations, full hospital admissions, and increased clinic workloads. Previously published techniques recommend a local penile block performed at the end of the surgery for improved management of postoperative pain [5,10]. It is known that local anesthesia can be effectively and safely applied in minor penis surgeries in adults such as circumcision, short frenulum plasty, meatotomy, fulguration of penile or meatal warts [3].…”

Section: Discussionmentioning

confidence: 99%

Repair of Adult Hypospadias Under Local Anesthesia: The Technique and Outcomes

Kalkan¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Bu klinik çalışmada; distal hipospadiası olan erişkin olgularda lokal anestesi ile hipospadias onarım tekniği ve sonuçları sunuldu. Gereç ve Yön-tem: 2000Yön-tem: -2010 yılları arasında yaşları 20 ile 24 (Ort.: 21.3) arasında deği-şen 24 olguda lokal anestesi ile hipospadias onarımı yapıldı. Hipospadias tipi 11 olguda koronal, 13 olguda subkoronal idi. Tüm olgular sünnetli idi. Tüm olgularda tübülerize insize plate üretroplasti (TIPU) tekniği uygulandı. Anestesik madde olarak penis köküne cilt altına prilocain hidroklorür 20 mg/ml, üret-ra içerisine % 2 lidocain içeren 12,5 g. Jel kullanıldı. Olgular Görsel ağrı skalası ile ağrı yönünden kayıt edildi. Olgular ağrı, lokal anestezinin komplikasyonları, operasyon süresi, erken ve geç komplikasyonlar yönünden değerlen-dirildi. Bulgular: Tüm olgular operasyonu kolay tolere ettiler. Peroperatif visü-el ağrı skalası (VAS) ortalama 2,04 (0-4) olarak bulundu. Operasyon süresi 16 ile 35 dakika (Ort.: 24 dk.) idi. Bir olguda operasyon sırasında senkop gelişti. 3 olguda üretral fistül gelişti. Fistüller lokal anestezi ile kateter kullanmaksı-zın outpatient olarak onarıldı. Meatal darlık, kötü kozmetik görünüm gözlen-medi. Tartışma: Lokal anestezi ile TIPU tarzı hipospadias onarımının erişkin distal hipospadiaslı olgularda kabul edilebilir ağrı ile birlikte güvenle uygulanabilir olduğu gösterildi. Anahtar KelimelerErişkin; Hypospadias; Local Anestezi; Teknik; Visual Analog Ağrı Skalası Abstract Aim: In this study, we evaluated the outcomes of a hypospadias repair technique using local anesthesia in adult patients with distal hypospadias. Material and Method: Hypospadias repair was performed under local anesthesia in 24 cases of circumcised males from 2000-2010. The type of hypospadias was coronal in 11 cases and subcoronal in 13 cases. Tubularised incisedplate urethroplasty method was used in all of the patients. Subcutaneous prilocaine hydrochloride was administered into the root of the penis and 12.5 g of a gel containing 2% lidocaine was administered into the urethra as an anesthetic agent. The patients' pain levels were assessed using the Visual Analogue Scale (VAS). Patients were evaluated in terms of pain level, duration of the operation, and early and late complications. Results: All patients easily tolerated the operation, with a mean postoperative VAS pain assessment of 2.04 (0-4). The duration of the operation ranged between 16 and 35 min. One of the patients developed syncope during the operation. Urethral fistula was seen in three patients. No incidence of meatal stenosis or poor cosmetic appearance was observed. Discussion: Hypospadias repair under local anesthesia was demonstrated to be safely practicable with an acceptable degree of postsurgical pain in adult patients with distal hypospadias.

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“…Ketamine local anaesthetics combinations have been demonstrated to speed the onset of analgesia, prolong the duration of caudal analgesia, and reduce the incidence of ineffective analgesia [6,7]. Ketamine has been shown to have a synergistic effect with caudal local anaesthetics [8].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Caudal Ketamine with Different Concentrations of Levobupivacaine for Postoperative Analgesia in Paediatric Subumblical Surgeries

Mogahed¹,

Salama²

2017

J Anesth Clin Res

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Nonopioid additives to local anaesthetics for caudal blockade in children: a systematic review

Cited by 154 publications

References 75 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Repair of Adult Hypospadias Under Local Anesthesia: The Technique and Outcomes

Efficacy of Caudal Ketamine with Different Concentrations of Levobupivacaine for Postoperative Analgesia in Paediatric Subumblical Surgeries

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